Signs of Teen Drug Use - J. Flowers Health Institute - Bespoke Diagnostics & Treatment

How to Tell if Your Child is Using Drugs?

Learn the Signs of Drug Use in Teens

How to Tell if Your Child is Using Drugs?

Learn the Signs of Drug Use in Teens

Table of Contents

How Common is Drug Use by Teens?

According to the National Institutes of Health, alcohol is the most commonly used drug by 8th-Graders, 12Th-Graders, and College Students.1


of 8th-Graders Use Alcohol


of 12th-Graders Use Alcohol


of College Students Use Alcohol

Marijuana is the next most common drug.


of 8th-Graders Use Marijuana


of 12th-Graders Use Marijuana


of College Students Use Marijuana

Is it Getting Better?

The good news is that according to the 2018 Monitoring the Future Survey, teenage drug abuse, aside from marijuana use, is at its lowest level in over two decades.2 Among 12th graders, past-year use of illicit drugs other than marijuana has declined by 30 percent since 2013. According to the survey, substances at historically low levels of use among teenagers include cigarettes, alcohol, heroin, prescription opioids, meth, sedatives and ketamine.

The bad news, many teenagers are still abusing drugs, including more than 12% of high school seniors. We will explore the signs of drug use in teens, including risk factors for teenage drug abuse, signs of teen addiction, and what parents can do if they believe their child is abusing drugs.

Drug Use and the Adolescent Brain

Teenagers demonstrate plenty of mental ability with regard to rational decision making and understanding right versus wrong. However, the teenage brain does not have fully-developed control processes. This leads to teens to respond to stressful or emotional decisions with impulsiveness. They fail to consider the consequences of their actions.3

16 to 17 year old children are more:

  • Vulnerable to peer pressure
  • Aggressive
  • Impulsive
  • Reactive to stress
  • Focused on short-term gratification rather than long-term consequences

Adolescence is a normal time a child to experiment. Over 50% of young people will try an illegal drug as a teenager, and nearly 100% will have tried alcohol, tobacco, or both at least once before they reach legal age.

Over 50% of Young People Will Try an Illegal Drug as a Teenager

Surveys show that for Americans aged 15-20, 12.2% meet the definition of an alcohol dependence disorder. This percentage is much higher in comparison to other age groups. For example, the rate of alcohol dependence was at 4.1% for those in the age range of 30-34.

Vulnerability to Drug Use: Children vs. Adults

Neuro-developmental studies show that a teenager’s developing prefrontal cortex leads to more emotional and impulsive decision-making. Adolescents also show a lower sensitivity to intoxication than adults due to higher metabolic rates allowing them to consume higher amounts of alcohol. These factors, combined with hormones that increase social competitiveness, promote drug use in children looking for social approval from their peers.

Teen Drug Use and Memory

A study shows that teens with alcohol use disorder show 10% smaller volume in the hippocampus (the main brain structure for memory) and displayed greater difficulty retrieving memories than peers without a history of alcoholism.

Marijuana Use and Brain Development

Researchers at Rosalind Franklin University School of Medicine looked at the effect of constant exposure to cannabinoids had on brain development. They found that during early adolescence, the growth of the child’s prefrontal cortex is slowed. This leads to changes in decision-making, personality, and social behavior.4

Most Abused Substances by Teens

Any use of substances by teenagers is considered abuse. The brain continues to develop into the 20’s, making substance use dangerous to brain development. According to the Monitoring the Future Study, the following are the most used substances by teenagers:


With more than half of high school seniors admitting to drinking in the past year, alcohol remains the most abused substance by teenagers.


Approximately 36% of high school seniors admit to using marijuana in the past year and 22% of high school seniors admitting using it during the past month. Marijuana is the only substance to see an increase in use over the years.

36% of High School Seniors Used Marijuana in the Past Year


Cigarette use is on a decline, however, the use of vaping or other e-cigarette products is increasing. This may be due in part to a misconception that vaping is somehow safer than cigarettes when there is no evidence of that.


Around 4% of high school seniors admitted to using Adderall in the last year. Although there is no evidence to support the idea that Adderall will improve academic or athletic performance, teenagers sometimes still believe it will help.

4% of High School Seniors Used Adderall in the Last Year


This category of substances includes Benzodiazepines like Ativan, Xanax, Klonopin, and Valium as well as Barbiturates like Phenobarbital and butalbital. Sleep Medications like Ambien and Lunesta are also a tranquilizer. More than 6 percent of high school seniors admit to tranquilizer use in the last year.


Also known as “synthetic marijuana” these dangerous substances are perceived by some as “safe” when in fact it can cause violence and aggression along with paranoia and anxiety. Around 3% of high school seniors have used spice in the last year.

3% of High School Seniors Used Spice in the Last Year


Sometimes people think that prescriptions are somehow safer because they are prescribed by a Doctor. The truth is, painkillers such as OxyContin are just as dangerous. Around 2 percent of high school seniors admit to using Oxycontin in the last year.

2% of High School Seniors Used Oxycontin in the Last Year


Around 4% of students admit to having ever abused inhalants, however around 1% admit to using them in the last year and less than 1% admit to abuse in the last month.

4% of Students Admit to Abusing Inhalants


Psychoactive substances include LAD, Peyote, Mescaline, Mushrooms and DMT. Around 6% of high schoolers admit to having ever used hallucinogens.

6% of High Schoolers Have Used Hallucinogens

Cough Medicine

Approximately 3% of high school seniors admit to abusing cough medicine in the past year. Abusing this substance can result in brain damage and nausea.

3% of High School Seniors Admit to Abusing Cough Medicine

The Rise of Vaping

Vaping is a type of electronic nicotine delivery system. They are used to simulate smoking using vapor instead of smoke. These devices have been marketed to teens as a safer alternative to cigarettes. Vape companies even use flavoring in the vapor that would appeal to children, but this practice has been curtailed by the U.S. Government.

How Many Children Vape? 5

  • Over 5 million children reported vaping in 2019.
  • 33% of users vape daily
  • Children are almost 20 times more likely to vape than adults
  • Vaping in children rose nearly 2000% from 2010-2020
  • Over 70% of high school smokers use both cigarettes and vape

According to a National Institutes of Health article, Dr. Richard Miech of the University of Michigan stated “vaping is reversing hard-fought declines in the number of adolescents who use nicotine . . . these results suggest that vaping is leading youth into nicotine use and nicotine addiction, not away from it.”​​​6

Teen Drug Abuse, Dependence, and Addiction

Drug abuse, addiction, and dependence are not the same things, and understanding the differences can help you determine the level of help your child needs if they are abusing substances.

Drug Abuse Dependence and Addiction - J. Flowers Health Institute - Bespoke Diagnostics & Treatment

Drug Abuse

Drug abuse is the act of using drugs or alcohol in a way that causes problems, such as relationship problems, troubles in school, behavioral problems, and mental or physical illnesses.

Any drug or alcohol use by teenagers is considered drug abuse because these substances interfere with normal brain development.

This impact on brain development can increase the risk of cognitive, behavioral, or emotional problems later on.


Dependence occurs when you need one or more drugs to function. Dependence develops as the brain changes to compensate for the chemical changes in the brain caused by drug use.

This produces tolerance. Tolerance happens when a person no longer responds to a drug in the way they did at first. So it takes a higher dose of the drug to achieve the same effect as when the person first used it. which means that increasingly larger doses are required to get the same effects.


Addiction is a term that means the compulsive physiological need for and use of a habit-forming substance and includes: 

  • tolerance
  • well-defined physiological symptoms upon withdrawal

When struggling with an addiction, you may find it challenging to quit even though you want to or try to.

Addiction affects the structures and functions of the brain and causes changes in thought and behavior patterns. Addiction almost always has underlying causes, which commonly include chronic stress, a history of trauma or a mental illness like anxiety, depression or an eating disorder.

Substance Use Disorder Criteria

Drug abuse, addiction, and dependence are now diagnosed under the umbrella of “substance use disorder”, which is characterized as mild, moderate, or severe, depending on how many of the following criteria are met:

Alcohol Use Disorder Criteria

Alcohol use disorders are evaluated with the following questions.​​​7

In the past year have you:

Risk Factors for Teenage Drug Abuse

Some biological and environmental factors may increase your child’s risk of abusing drugs or alcohol. These include:

Family History of Drug or Alcohol Abuse

Genetics account for about half of the risk of developing a drug or alcohol addiction.

Impulse Control Problems

Teens who have trouble controlling their impulses are likely to engage in risky behaviors, including abusing drugs or alcohol.


Children who have experienced trauma, such as witnessing death or violence, being a victim of physical or sexual abuse, or surviving a natural disaster, are at a higher risk for substance abuse problems later on. A number of therapies can help reduce the impact of trauma.

Mental Health Problems

Anxiety, depression, ADHD, eating disorders, and other mental illnesses increase the risk of self-medicating, substance abuse, and addiction. Getting treatment for these conditions can help reduce the risk.

Peer Pressure and Pop Culture

Teenagers frequently must deal with peer pressure and popular culture, which often glamorizes drug abuse. Teens who are stressed or unhappy may turn to drugs or alcohol in an attempt to feel better. Some teens abuse drugs out of boredom or rebellion and some use it in order to feel more confident or “cooler.”

Myths About Teenage Drug Use

Unfortunately, teenagers are likely to be sorely misinformed about the dangers of drugs and alcohol. For example, according to the Substance Abuse and Mental Health Services Administration, one-fourth of all teenagers believe that prescription drugs are safe because they’re prescribed by a doctor.8

But as the opioid crisis has proven, this couldn’t be any farther from the truth. Similarly, some teens believe marijuana is safe, but the fact is that teenage marijuana abuse can knock as many as eight points off an IQ, later on.

Spending quality time with your child and educating your child early on about the realities of drugs and alcohol abuse are two of the most powerful deterrents for teenage drug abuse.

Alcoholism and Drug Abuse in Teenagers

Signs of Teenage Drug Use

If you suspect your child is using drugs or alcohol, you’ve probably seen some signs that raise red flags. You can listen to your instincts, and should also follow them up with concrete, observable proof, which will help you confront your teenager about the abuse.

Signs that your teen may be abusing drugs or alcohol include:

If you strongly suspect your child is using drugs, don't be afraid to conduct a search of their bedroom or phone for evidence. You may feel like you are invading their privacy, but it could also save their life.

Where Could My Teen Hide Drugs?

If you are concerned your child may be hiding substances, there are some frequent locations and tricks used to conceal substance use.

Game Consoles

Unused consoles or controllers have empty spaces that are sometimes used to conceal substances. The battery compartment of the unused controller is frequently used by teenagers as a secret spot.

Stash Cans

Stash cans can be designed into any regular looking item that you may see in your child’s room. They can be anything from a shaving can, to WD- 40 to Jiffy. If you notice an unmoving Mountain dew can, it may be garbage, or it may be hiding substances.

Office Supplies

Writing utensils like pens, markers, or highlighters all have some empty space that can be used to conceal drugs. Of course, items like books may also be hollowed out to contain objects or substances as well.

Beauty and Hygiene Items

Items such as lipsticks and lip glosses can be hollowed out or used to conceal substances. Feminine hygiene items have also been used to conceal substance.

Outside or En Route

Consider your child’s regular routine. Do they drive to school? They may be concealing substance in the vehicle. Do they walk to school or other activities?

They may choose to hide substances in places they frequently pass or know will remain undisturbed outside.

Consequences of Teenage Drug Use

When the developing body uses substances that change chemical functions, long-term effects can appear as a result of the abuse.

One of the consequences is a decline in academic performance. When substance use has a negative impact on a teen’s performance in school, it could also impact opportunities in the future such as acceptance into higher education.

Substance use is linked to poor judgment in social interactions, including sexual activity and impaired driving. When substances are used as a social lubricant from an early age, it can be more challenging later on for a person to develop social connections without substances. A citation due to substance abuse such as impaired driving or criminal charges could also have long-lasting effects.

Drug use also increases the risk of developing a mental health disorder like depression or anxiety.

The Health Consequences

Depending on the drug of choice, the severity of abuse, and existing physical health factors, a teenager is at risk of addiction, serious impairment, or death. Here is a list of commonly abused drugs and the associated health risks:7
Opioids - J. Flowers Health Institute - Bespoke Diagnostics & Treatment

Opioids (including prescription painkillers)

Respiratory issues or death from overdose.

Marijuana - J. Flowers Health Institute - Bespoke Diagnostics & Treatment


Impaired memory, learning, problem-solving, and concentration. Higher risk of psychosis later in life like paranoia, hallucinations, and schizophrenia.

Vaping - J. Flowers Health Institute - Bespoke Diagnostics & Treatment

Electronic Cigarettes (Vaping)

Despite being smoke-free, those who vape are still exposed to harmful substances similar to those found in traditional cigarettes including the addictive substance Nicotine.

Methamphetamines - J. Flowers Health Institute - Bespoke Diagnostics & Treatment


Psychotic behavior

Cocaine - J. Flowers Health Institute - Bespoke Diagnostics & Treatment


Heart attack, stroke, and seizures.

Inhalants - J. Flowers Health Institute - Bespoke Diagnostics & Treatment


Damage to the heart, lungs, liver, and kidneys.

Ecstacy - J. Flowers Health Institute - Bespoke Diagnostics & Treatment


Liver or heart failure.

Generation RX: The New Teen High

for the SATs ecstasy suboxone a bunch of pills  00:11
don’t I don’t know Benita her just take
them prescription medicines have become
the new drug of choice among teenagers
they’re easily available potent and
highly addictive they’re also quite
dangerous if misused in that there
really is a potential to overdose and
die when using these things hospital
emergency rooms are already seeing a
dangerous new trend way ahead nationally
of deaths from heroin our deaths from
overdoses of oxycodone oxycontin vicodin
hydrocodone and methadone addicted at 15
kalenna has been popping pills and
smoking pot since she was 12 now 18
she’s been in and out of emergency rooms
for the past three years there are many
times I could have died and I didn’t for
some reason more than one-third of
prescription drug abusers are between
the ages of 12 and 17 and studies show
the younger a person starts using drugs
the more likely they are to become
addicted are we stocked that I could
control it by the time they come and see
us people feel like their lives are very
much out of control teens today have
greater access to drugs than ever before
most of it coming from family and
kids have access at home to what’s in
the medicine cabinet of their parents or
their grandparents and often those will
include oral doctor prescribed narcotics
I think that the first thing that
parents should really do is to know what
they have in their medicine cabinet and
to keep careful tabs of it as they would
anything else that’s dangerous to kids
in the house like firearms or alcohol
so-called study drugs given to those
with ADHD attention deficit and
hyperactivity disorder are increasingly
being abused by teenagers you know store
in like smaller pills like adderall and
Ritalin and getting them from people who
were prescribed them I found like I
could focus more in school because I
would stay up all the time and I could
do essays and I loved it there’s no
proof these drugs improve grades and
taken without a prescription
doctors say these stimulants can lead to
exhaustion abnormal heart rhythms even
confusion and psychosis just because a
drug is legal it doesn’t necessarily
mean that it’s safe teams even parents
often suffer from the misguided belief
that these drugs are safer because
they’re prescribed by a medical doctor
when it comes to abuse parents often
don’t know the warning signs and kids
don’t know the dangers a lot of kids in
school smoke pot I think it’s okay to
pills think it’s okay just like I did I
know exactly how they feel and exactly
what they’re thinking that it’s okay and
nothing’s gonna happen but prescription
painkillers now top car crashes as the
leading cause of accidental death in the
US and in New Hampshire the number of
drug overdose deaths have doubled since
2002 people who are addicted to opioids
whether they’re shooting it
intravenously or taking pills at some
point if they live long enough they’re
going to accidentally overdose it’s kind
of like playing with fire you’re gonna
get burned too often parents say not my
child it would never happen but
prescription drug abuse is an
equal-opportunity epidemic it doesn’t
really spare anybody
we need to get upset about it because
it’s a real waste of our younger
generation when they get killed or died
in a car wreck or died in an overdose or
hurt somebody else it’s not a game you
know and if you play it like a game
you’re going to lose

What to Do if Your Teen is Using Drugs

Educate Yourself

The most important thing you can do if you suspect your child is abusing drugs is to learn everything you can about substance use disorders and the specific drug your teen is abusing. The National Institute on Drug Abuse is an invaluable, trustworthy resource for information about drug abuse and specific drugs.9

Talk to Your Teen

Armed with information and keeping in mind the signs of drug abuse you’ve noticed in your child, have a talk with your teen. Stay calm. Explain that you suspect there has been drug use, and point out the evidence.

Expect that your teen may deny using, or that they may become angry or defensive. Remain calm and express your love for your child.

Before your conversation, decide on the consequences of drug abuse and the rules moving forward. Choose consequences and rules that are realistic and enforceable.

Seek Help

If your child abuses drugs chronically or has developed an addiction to drugs or alcohol, professional help may be necessary.

According to the National Institute on Drug Abuse, addiction almost always requires professional help to overcome.10

Treatment works for most people who engage with their program and stay in treatment for an adequate period of time.

Treatment helps people develop skills and strategies needed to cope with powerful triggers like stress, negative emotions, and cravings. It helps show purpose and meaning in a life without drugs or alcohol, and it helps teach how to have fun and enjoy life without using.

Convey Love and Hope

Hope is the foundation of recovery from a substance use disorder, according to the Substance Abuse and Mental Health Services Administration.11

Hope is the belief that a better future is possible, and conveying this hope to your child is very important.

Let your child know that you love them and want the best for them, and that you believe they can find happiness in a life without using drugs or alcohol.

Get Support

Joining a support group for parents whose teens have a substance use disorder can help you cope with your own difficult emotions, and it can help you find resources for helping your child recover from a substance use disorder.

There are many ways to find a support group online or in-person, including talking to a doctor, counselor, social worker, or treatment center.

Talking to Your Teen About Drug Use

The earlier you start the conversation about drugs, and the more open the conversation with your teenage, the more likely your teenager will make healthy choices when presented with the opportunity to try drugs.

Here are several tips for effective and open communication about drugs with a teenager:12

Discuss the reasons why they shouldn’t use drugs

This is not a time to use scare tactics. Rather, emphasize how drug use takes away from the things that are important to your teen, whether that’s appearance, sports, driving, or school grades.

Choose a time when everyone is calm and sober

It’s not ideal to have a conversation about drugs when you or your teen is angry or under the influence of substances. These circumstances prevent effective communication.

Discuss media messages

Try to understand what your teen sees and hears through social media, TV, movies, and songs that glamorize drug use. Prepare to talk about your own drug use.

It is normal for your teen to ask you about your own experience with drugs. If you chose not to use drugs, explain why you made that choice. If you did use drugs, be sure to share the lessons you learned from those experiences.

Strategize ways to resist peer pressure

Brainstorm together about ways they can turn down offers of drugs in social situations. This will prepare them to make healthy choices on their own. See it from your teen’s perspective.

This is not a one-way conversation, so avoid lecturing your teenager. It is more effective to listen to your teen’s opinions and questions about drugs. Show your teen that they can be open and honesty with you.

Additional Prevention Tips

While talking with your teenager about drug use can go a long way in preventing their own premature experimentation, there are many more ways you can help your child avoid drug use:13

Lead by Example

Use prescription drugs only as directed. Don’t use illicit drugs. If you drink, do so in moderation. Show your child what a healthy lifestyle looks like.

Be Aware of Your Child's Activities

Pay attention to where your teen spends their time. Encourage adult-supervised activities that they are interested in.

Know Your Teen's Friends

If your child’s friends use drugs, your child might feel more pressure to use drugs too. Getting to know your teen’s friends also opens the opportunity to foster trust and open communication between you and your teen.

Enforce Rules and Consequences

Clearly communicate your family rules and the consequences of not following those rules. Consistency is key.

Keep Track of Prescription Drugs

Stay aware of all medications in your home.

When It's Time for Addiction Treatment

By the time and addiction has developed, good intentions and willpower are rarely sufficient to overcome an addiction for good. This is because addiction rewires the brain’s reward system.
A properly functioning brain ‘rewards’ a person with good-feeling dopamine when they do activities needed to thrive, such as eating, playing sports, or spending time with family and loved ones.
When a teenager suffers from addiction, their brain has become so conditioned to getting a ‘reward’ from using a drug that they have a hard time getting the same pleasure from the healthy things they used to enjoy.

Principles of Effective Treatment

The National Institute on Drug Abuse outlines an extensive list of guiding principles for effective treatment.14

These principles include but are not limited to the following:

  • Addiction is a complex but treatable disease that affects brain function and behavior
  • No single treatment is appropriate for everyone suffering from addiction
  • Treatment needs to be readily available
  • Effective treatment treats more than just a person’s drug abuse
  • It is critical to remain in treatment for an adequate period of time
  • A person’s treatment plan must be assessed continually and modified as appropriate
  • Treatment does not need to be voluntary to be effective

What to Look for in a Treatment Program

If your teenager suffers from addiction, effective treatment will be vital to ending the drug abuse for the short-term while also preventing relapse for the long-term. Choosing the right treatment program for your child will give them the best chance at a successful recovery.

High-Quality Treatment Program Checklist:

  • Emphasis on evidence-based therapies
  • Individualized treatment plan for your teen
  • Encouraged family involvement
  • Staff that is fully licensed and trained
  • Comfortable and safe facility environment
  • Aftercare plan for ongoing success
  • Adheres to the NIDA Principles of Effective Treatment (described above)